A polypill is suggested containing all 4 classes of guideline-directed medical therapy for heart failure
Justin Chen, MD, First Year Cardiology Fellow, First Author along with Anubha Agarwal, MD, MSc, Assistant Professor of Medicine, Co-Director, Program in Global Cardiovascular Health, WashU Medicine Cardiovascular Division, Senior Author, have published in Circulation: Cardiovascular Quality and Outcomes.
The findings from this mixed methods research, “Stakeholder Perspectives on a Heart Failure With Reduced Ejection Fraction Polypill: A Multi-Center Mixed Methods Study”, lay the foundation for future randomized controlled trials evaluating a polypill-based approach for patients with heart failure with reduced ejection fraction in the United States.
This multi-center mixed methods study demonstrates that a polypill-based strategy for treatment of patients with heart failure with reduced ejection fraction is perceived to be highly acceptable, appropriate, and feasible by both patients and physicians. Based on this data, our team developed a conceptual framework that will directly inform future randomized clinical trials of polypill-based strategies to change the paradigm of heart failure care.
Anubha Agarwal, MD, MSc
Heart failure is one of the leading public health problems in the United States, with poor clinical outcomes for patients with heart failure with low ejection fraction (HFrEF). Guideline-directed medical therapy (GDMT) for patients with HFrEF, which included a Beta-blocker, mineralocorticoid receptor antagonist, sodium-glucose contransporter-2 inhibitor (SGLT2i), and angiotensin-converting enzyme inhibitor/angiotensin receptor block/angiotensin receptor-neprilysin inhibitor (ARNi), provides an estimated 73% reduction in mortality at 2 years. A HFrEF polypill has been proposed as an implementation strategy to bridge the gap between evidence and clinical practice, improving the care of patients with HFrEF.
Special thanks goes to Thomas Maddox, MD, MSc, Professor of Medicine
Vice President, Digital Products and Innovation, BJC HealthCare for helping facilitate the ACC survey presented in the paper.